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 Original Articles |
| A Clinical Analysis of 27 Patients with Candidemia |
| Hyoung Shik Shin, Kyong Ran Peck, Hyun Ju Pae, Mun Hyun Jung, Myoung Don Oh, Kang Won Choe |
| Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea |
Vol.23 Num.4 (p257~263)
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We reviewed 27 patients with candidemia who were admitted to the SNUH from January 1981 to June 1990.
The observed results were as follows.
1) The range of age was from 17 to 69 years and the median age was 49 years. Male to Female ratio was 15:12.
2) The underlying diseases were acute leukemia in 10, solid tumor in 4, nononcologic disease in 13.
3) The predisposing factors associated with candidemia were antibiotic therapy (100%), central venous catheter insertion (70%), cytotoxic chemotherapy (37%), neutropenia (33%), preceding surgery (33%), corticosteroid therapy (15%) and hyperalimention (11%).
4) Infecting species were C. albicans in 9 cases, C. tropicalis in 9, C. parapsilosis in 4, C. guilliermondii in 2, C. glabrata in 2 and C. lusitaniae in 1. Infecting species were C. tropicalis in 6 of 9 cases with neutropenia, and C. albicans in 4 of 6 cases with preceding abdominal surgery.
5) The serum specimens from 12 patients were examined for circulating Candida protein antigen with Cand-Tec. One case had a antigen titer of 1:8, 2 cases 1:4, and 7 cases 1:2.
6) In 7 patients with invasive candidasis, involved organs were lung in 3 cases, kidney in 2 cases, spleen in 2 cases, and liver, heart, CNS, retina and skin in 1 case respectively.
7) Overall mortality was 30%. In 14 patients who recieved amphotericin B therapy, 3 patients expired. Two patients who recieved fluconazole therapy were cured. Six patients were cured only with the correction of predisposing factors. Five patients who were presented with septic shock at theonset of candidemia expired without specific antifungal therapy.
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